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Carditis is associated with Helicobacter pylori-induced gastritis and not reflux esophagitis
Tae Jung Jang1, Nam Il Kim, Chang Heon Yang
1Department of Pathology, Dongguk University College of Medicine, 707 Sukjang-dong, Kynogju, Kyongbuk 780-714, Korea. taejung@mail.dongguk.ac.kr
Insights
Chronic inflammation in the gastric cardia is linked to infection, not reflux disease. Cardiac-type mucosa prevalence increases with gastritis, atrophy, and age in this region.
Area of Science:
- Gastroenterology
- Pathology
Background:
- The pathogenesis of chronic inflammation in the gastric cardia remains unclear.
- The normal structure of cardiac-type mucosa in the cardiac region is debated.
Purpose of the Study:
- To investigate correlations between carditis, infection, and gastroesophageal reflux disease (GERD).
- To determine the prevalence of cardiac mucosa in the endoscopically defined cardiac region.
Main Methods:
- Analysis of gastric biopsy specimens from 57 participants (27 with reflux esophagitis, 30 without).
- Histopathological examination for carditis, gastritis, atrophy, and cardiac-type mucosa.
Main Results:
- Carditis was associated with infection, not reflux esophagitis.
- Gastritis and atrophy at the cardia correlated with findings in the antrum and body.
- Cardiac mucosa prevalence was linked to carditis severity, gastritis, atrophy, and patient age.
Conclusions:
- Infection-induced pangastritis may contribute to carditis development.
- Carditis is associated with the presence of cardiac-type mucosa in the gastric cardia.
- Cardiac-type mucosa is not consistently found in the endoscopically defined cardiac region.
Abstract:
Pathogenesis of chronic inflammation at the gastric cardia is not yet clear. It is controversial whether cardiac-type mucosa is normal structure at the cardiac region. Therefore, we studied the existence of correlations between carditis, infection, and gastroesophageal reflux disease, and determined the prevalence of cardiac mucosa at the endoscopically defined cardiac region. Gastric biopsy specimens were analyzed from 27 patients with reflux esophagitis and 30 subjects without reflux esophagitis. Carditis was not associated with reflux esophagitis, but with infection. Moreover, the degree of gastritis and atrophy at the cardia were closely related to those of the antrum and body. Cardiac mucosa was not always present in the endoscopically defined cardiac region, and its prevalence was positively correlated with gastritis and atrophy grade of the cardia and age. In conclusion, -induced pangastritis may lead to the development of carditis, which is associated with occurrence of cardiac-type mucosa at the cardiac region.